<%@ page language="java" contentType="text/html; charset=US-ASCII"
    pageEncoding="US-ASCII"%>
<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=US-ASCII">
<title>Add or Modify Hospital Status</title>
</head>
<body background="images/eddie-hoptoit.png">


<form>


  Hospital Name: <input id="name" ><br>
  Type           <select value="er">   
  <option>Trauma Center ER
  </option> 
  <option>General Hospital</option>
  <option>Clinic</option>
  </select>
  
  <br>
  
  <input type="submit">
  
</form>

</body>
</html>